Healthcare Provider Details

I. General information

NPI: 1396077582
Provider Name (Legal Business Name): HILLTOP AMBULATORY SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2010
Last Update Date: 05/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5035 MAYFIELD RD SUIITE # 100
LYNDHURST OH
44124-2688
US

IV. Provider business mailing address

5035 MAYFIELD RD SUITE # 100
LYNDHURST OH
44124-2688
US

V. Phone/Fax

Practice location:
  • Phone: 216-923-0666
  • Fax: 216-432-1136
Mailing address:
  • Phone: 216-923-0666
  • Fax: 216-432-1136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number0965AS
License Number StateOH

VIII. Authorized Official

Name: DR. RODNEY A. GREEN
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 440-449-8880